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2025 ICD-10-CM code H47.033

Optic nerve hypoplasia, bilateral. This is a congenital condition where the optic nerve is underdeveloped, affecting both eyes.

Code H47.033 should be used when both optic nerves are affected by hypoplasia.If only one eye is affected, use H47.031 (right) or H47.032 (left). If associated with other conditions, such as septo-optic dysplasia, additional codes should be used to reflect these diagnoses.

Medical necessity for services related to H47.033 is established by the presence of visual impairment and/or associated conditions requiring medical intervention. This may include ophthalmological assessments, neuroimaging, endocrine testing, and other specialist consultations. The specific medical necessity criteria may vary depending on the payer and the services being rendered.

Diagnosis and management of ONH involves ophthalmologists, neurologists, and endocrinologists. Ophthalmologists assess visual function and eye health. Neurologists evaluate brain structure and function. Endocrinologists manage hormonal imbalances if present. Other specialists, such as developmental pediatricians, may be involved depending on the individual's needs.

In simple words: Optic nerve hypoplasia is a birth defect where the optic nerve, which connects the eye to the brain, is smaller than normal in both eyes. This can cause vision problems ranging from blurry vision to blindness.It can sometimes occur with other health issues, like problems with certain brain structures or hormone imbalances.Diagnosis usually involves an eye exam and possibly a brain scan (MRI). Treatment focuses on managing vision problems and any related conditions.

Optic nerve hypoplasia (ONH) is a congenital condition characterized by underdevelopment of the optic nerves, which transmit visual information from the retina to the brain. In bilateral ONH, both optic nerves are affected. This condition can present with a range of visual impairments, from mild to severe, including blindness.It is often associated with nystagmus (involuntary eye movements) and strabismus (misaligned eyes). ONH can also be part of a broader spectrum of conditions, sometimes referred to as septo-optic dysplasia, which may involve brain malformations and pituitary gland dysfunction. These can lead to hormonal imbalances and developmental delays. Diagnosis involves a thorough eye exam and imaging studies like MRI to assess the optic nerves and brain structures. Treatment focuses on managing symptoms and associated conditions.

Example 1: A newborn infant is noted to have involuntary eye movements (nystagmus) and difficulty fixating on objects. An ophthalmological exam reveals small optic nerves bilaterally, leading to a diagnosis of H47.033., A child with known septo-optic dysplasia, exhibiting hormonal deficiencies and developmental delays, is found to have bilateral optic nerve hypoplasia (H47.033) upon ophthalmic evaluation., An infant with poor visual behavior undergoes an MRI, which reveals an absent septum pellucidum.Further investigation and eye exam confirm the presence of bilateral optic nerve hypoplasia, coded as H47.033.

Documentation should include a detailed ophthalmological exam report describing the appearance of the optic nerves, visual acuity assessment, presence of nystagmus or strabismus, and any other relevant ocular findings.Brain imaging reports (MRI) are essential to assess for associated brain abnormalities. Endocrine evaluations, if conducted, should be documented as well, including hormone levels and any associated clinical manifestations.

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